Dr. Ana Leonor Acosta, Pediatrician, Coordinator of the Pediatric Pavilion of the General Hospital of the Plaza de la Salud (HGPS).
Dengue is a febrile disease caused by a virus, dengue virus (DENV) belonging to the Flavivirus genus of the Flaviviridae family.
It has four serotypes, called DENV-1, DENV-2, DENV-3 and DENV-4 and affects billions of people, especially in tropical and subtropical regions, areas of South and Central America, Southeast Asia, South Pacific, Africa and the Caribbean, constituting a major health problem worldwide, with a high hospitalization rate in both children and adults.
According to the report given by the World Health Organization (WHO) it is estimated that around 3,000 million people live in areas at risk of getting dengue, with approximately 390 million infections and about 20,000 deaths from dengue per year.
Transmitting mosquitoes Dengue transmission is caused by the bite of the female mosquito Aedes aegypti, and less frequently by Aedes albopicttus.
Aedes aegypti, originally from Africa, migrated to the Americas during the fifteenth to seventeenth centuries aboard ships carrying slaves and is currently distributed in the tropical and subtropical regions of the world. This species itches during the day.
The migration of the Aedes albopictus mosquito, native to the East and India is more recent, occurred in the last two or three decades. The adult mosquito lays its eggs on the inner walls of the containers with water, above the water level; being in an aqueous environment, the egg incubation process can last from days to months until it becomes larvae. The larvae in five days become chrysalis, which live in the water and in two to three days go into adulthood.
The open water pond places, such as tires (rubbers), buckets, tanks, glasses, vases, cans, bottles, cisterns, barrels and ditches, among others, are conducive to the development of mosquitoes. This favors greater opportunities for disease transmission.
Transmission. When the mosquito bites a person infected with dengue, he ingests blood with the virus, which is incubated in the mosquito for a period of 8 to 12 days. Subsequently, the mosquito transmits the virus by biting another person, which can show symptoms of the disease after five to seven days. In this way the infection spreads.
Dengue classification. The classification recommended by the WHO establishes two forms of disease, dengue and severe dengue.
Within the first form of disease are dengue without warning signs and dengue with alarm signs.
Dengue without warning signs corresponds to the picture manifested as a nonspecific febrile syndrome; the diagnosis is suspected when other cases have been confirmed in the sector to which the patient belongs.
Dengue with warning signs corresponds to the patient who has severe abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, hepatomegaly (increase in liver size) and progressive hematocrit increase.
Severe dengue is characterized by the presence of one or more of the following parameters:
1. Shock due to plasma extravasation, fluid accumulation with respiratory distress, or both.
2. Profuse bleeding.
3. Severe organ commitment. Liver with elevated levels of liver enzymes; central nervous system (CNS) with impaired consciousness, among others.
The illness. Although the progression of severe dengue disease can occur in any patient depending on the aggressiveness of the virus, patients under one year of age, those over 65, pregnant women and those with other pathological conditions are more susceptible to complications, such as diabetes, heart disease, kidney disease and malnutrition, among others. However, in general cases of dengue have good evolution and can be treated in any health center with trained personnel and with adequate clinical follow-up. If the patient evolves favorably, after a proper clinical management, the recovery stage begins with fluid reabsorption.
Improvement of the general condition and remission of the disease. After the recovery of the disease, permanent immunity is acquired for the corresponding serotype, but not for the other serotypes, for which the patient will only have partial and temporary protection. Subsequent infections caused by one of the other serotypes increase the chances of suffering from severe dengue.
Posted in: Hoy Digital newspaper.